Does in-hospital breastfeeding self-efficacy predict breastfeeding duration?

Abstract

Background: Health Canada recommends exclusive breastfeeding for the first 6 months postpartum with continued breastfeeding up to 2 years and beyond. While 88% of Canadian mothers initiate breastfeeding, only 70% of mothers continue to do so at 4 weeks postpartum and only 14% are exclusively breastfeeding at 6 months. Breastfeeding self-efficacy is a potentially modifiable variable that has been associated with mothers’ breastfeeding practices. The Breastfeeding Self-Efficacy Scale (Short-Form) is an instrument that could potentially identify women with low breastfeeding self-efficacy during the in hospital period. Purpose: To describe the breastfeeding practices of new mothers in the Kingston, Frontenac and Lennox & Addington area and to assess the association between in-hospital scores on the Breastfeeding Self-Efficacy Scale (Short-Form) and duration of breastfeeding. Methods: This study was a secondary analysis of a dataset from the 2008 Infant Feeding Survey, a prospective study of 463 mothers with 12-month longitudinal follow-up. Data were weighted according to the maternal age distribution of the general population of new mothers. Breastfeeding practices were described using Kaplan-Meier survival distributions. Four outcomes were described: ‘exclusive breastfeeding from birth’, ‘exclusive breastfeeding from discharge’, ‘high breastfeeding’, and ‘any breastfeeding’. Using logistic regression, scores from the Breastfeeding Self-Efficacy Scale (Short-Form) were assessed for association with duration of ‘exclusive breastfeeding from birth’ and duration of ‘any breastfeeding’ (dichotomized as ‘less than 6 weeks’ and ‘6 weeks or beyond’). Results: The sample was highly educated (75% had post-secondary education) and reported high levels of household income (37% reported >$80,000/year). Six percent of mothers exclusively breastfed to 6 months. Close to one quarter (24%) of women sustained some extent of breastfeeding for 12 months. The relationship between scores on the Breastfeeding Self-Efficacy Scale (Short-Form) and duration of ‘exclusive breastfeeding from birth’ and the relationship between self-efficacy scores and duration of ‘any breastfeeding’ were identical (OR = 1.05) and non-significant (95% CI 1.0-1.1). Conclusion: This study did not show a significant relationship between in-hospital scores on the Breastfeeding Self-Efficacy Scale (Short-Form) and duration of breastfeeding. Given the high socioeconomic status of women in this study, further studies are warranted to confirm these results.